Department of Health

Medicaid Claims Processing for the Six Months Ended September 30, 2008

Medicaid claims are processed and paid by an automated system that is operated by a contractor and overseen by the Department of Health. We examined selected Medicaid claims processed during the six months ended September 30, 2008 to determine whether the claims were processed in accordance with procedures. We found that the claims were processed in accordance with procedures. However, we determined that three providers who had abused the Medicaid program, and should have been removed from the automated payment system, had not been removed from the system. We also identified certain overpayments that needed to be recovered and certain security weaknesses that needed to be addressed.